British Journal of Psychiatry, 196(1), January 2010, pp.13-17.
Publisher:
Cambridge University Press
Factors associated with depression are usually identified from cross-sectional studies. This article explores the relative roles of onset and recovery in determining these associations. Hazard ratios for onset and recovery were estimated for 39 risk factors from a cohort study of 10,045 general practice attendees whose depression status was assessed at baseline, 6 and 12 months. Risk factors have a stronger relative effect on the rate of onset than recovery. The strongest risk factors for both onset and maintenance of depression tend to be time-dependent. With the exception of female gender the strength of a risk factor’s effect on onset is highly predictive of its impact on recovery. Preventive measures will achieve a greater reduction in the prevalence of depression than measures designed to eliminate risk factors post onset. The strength of time-dependent risk factors suggests that it is more productive to focus on proximal rather than distal factors.
Factors associated with depression are usually identified from cross-sectional studies. This article explores the relative roles of onset and recovery in determining these associations. Hazard ratios for onset and recovery were estimated for 39 risk factors from a cohort study of 10,045 general practice attendees whose depression status was assessed at baseline, 6 and 12 months. Risk factors have a stronger relative effect on the rate of onset than recovery. The strongest risk factors for both onset and maintenance of depression tend to be time-dependent. With the exception of female gender the strength of a risk factor’s effect on onset is highly predictive of its impact on recovery. Preventive measures will achieve a greater reduction in the prevalence of depression than measures designed to eliminate risk factors post onset. The strength of time-dependent risk factors suggests that it is more productive to focus on proximal rather than distal factors.
Subject terms:
prevention, risk, depression, diagnosis;
Content type:
research
Location(s):
Chile, Estonia, Netherlands, Portugal, Slovenia, Spain, United Kingdom
CURY Silvia Patricia, ASTRAY Andres Arias, GOMEZ Jose Luis Palacios
Journal article citation:
European Journal of Social Work, 22(3), 2019, pp.526-540.
Publisher:
Taylor and Francis
This article presents the validity study for ISD-1 (Instrument for Social Diagnosis), designed to be used in the specialist field of intervention in care homes for older persons. The study has focused on the evidence regarding the validity of its content. The definition of the operative area of ISD-1 (social diagnosis in care homes), and its representativeness and relevance, are decisive aspects
(Edited publisher abstract)
This article presents the validity study for ISD-1 (Instrument for Social Diagnosis), designed to be used in the specialist field of intervention in care homes for older persons. The study has focused on the evidence regarding the validity of its content. The definition of the operative area of ISD-1 (social diagnosis in care homes), and its representativeness and relevance, are decisive aspects for its validity. Two validation procedures were used, with the participation of two independent groups of experts. Both procedures had the objective of obtaining a quantitative measure assessing the representation of the area and of the degree of association between the dimensions and the items of the instrument. This study suggests that there is a sufficient degree of evidence for the representativeness, relevance and usefulness of the content of ISD-1, meaning it may be considered a suitable instrument for the formulation of social diagnoses in care homes for older persons.
(Edited publisher abstract)
Subject terms:
instruments, care homes, nursing homes, older people, diagnosis, evidence, testing;
CURY Silvia Patricia, ASTRAY Andres Arias, GOMEZ Jose Luis Palacios
Journal article citation:
European Journal of Social Work, 22(3), 2019, pp.511-525.
Publisher:
Taylor and Francis
This article describes the design process and main features of an instrument developed for use in the specialist area of intervention in care homes for older persons. The essential aim of ISD-1 (instrument for social diagnosis) is to permit the correct formulation of social diagnoses and to standardise and define the professional language used by social workers. Its content has been organised into 4 dimensions of social diagnosis, divided into 15 sub-dimensions containing 83 diagnostic categories. This work was performed in Spain, in the 24 care homes of the Madrid Social Care Agency of the Community of Madrid, involving the participation of the 40 social workers practising in these centres. ISD-1 is an easily understood and used tool, of potential use for social workers practising in care
(Edited publisher abstract)
This article describes the design process and main features of an instrument developed for use in the specialist area of intervention in care homes for older persons. The essential aim of ISD-1 (instrument for social diagnosis) is to permit the correct formulation of social diagnoses and to standardise and define the professional language used by social workers. Its content has been organised into 4 dimensions of social diagnosis, divided into 15 sub-dimensions containing 83 diagnostic categories. This work was performed in Spain, in the 24 care homes of the Madrid Social Care Agency of the Community of Madrid, involving the participation of the 40 social workers practising in these centres. ISD-1 is an easily understood and used tool, of potential use for social workers practising in care homes for older persons and capable of being adapted for use in other institutional environments, as well as being capable of adaptation and translation for its application in other countries.
(Edited publisher abstract)
Subject terms:
care homes, older people, instruments, intervention, nursing homes, social work, diagnosis, screening;
Children and Youth Services Review, 73, 2017, pp.100-106.
Publisher:
Elsevier
Adverse family conditions, abuse and neglect during childhood present important risk factors for the appearance of emotional and behavioural problems. The main aim of this paper is to describe the presence of these kinds of disorders in children in residential child care and to explore individual, socio-family and care process factors associated with the use of mental health services. The sample consisted of 1216 children 6–18 years old in residential care in several Spanish regions. Information about emotional and behavioural problems was gathered according to two criteria: receiving some kind of treatment services and/or being identified as within the clinical range in the Child Behavior Checklist (CBCL). Results showed that 49% of cases were receiving some kind of mental health treatment and 61% were identified as within the clinical range in some of the broad band scales of the CBCL. In terms of agreement between referral to treatment and CBCL scores, results showed that four out of ten cases identified as within the clinical range were not receiving any kind of treatment. Several factors related to the type of problems detected in the CBCL, personal variables, and child care arrangements are associated with greater use of mental health services.
(Edited publisher abstract)
Adverse family conditions, abuse and neglect during childhood present important risk factors for the appearance of emotional and behavioural problems. The main aim of this paper is to describe the presence of these kinds of disorders in children in residential child care and to explore individual, socio-family and care process factors associated with the use of mental health services. The sample consisted of 1216 children 6–18 years old in residential care in several Spanish regions. Information about emotional and behavioural problems was gathered according to two criteria: receiving some kind of treatment services and/or being identified as within the clinical range in the Child Behavior Checklist (CBCL). Results showed that 49% of cases were receiving some kind of mental health treatment and 61% were identified as within the clinical range in some of the broad band scales of the CBCL. In terms of agreement between referral to treatment and CBCL scores, results showed that four out of ten cases identified as within the clinical range were not receiving any kind of treatment. Several factors related to the type of problems detected in the CBCL, personal variables, and child care arrangements are associated with greater use of mental health services.
(Edited publisher abstract)
Subject terms:
mental health problems, service provision, mental health services, looked after children, residential child care, screening, diagnosis, emotionally disturbed children, behaviour problems;
Dementia: the International Journal of Social Research and Practice, 15(5), 2016, pp.931-957.
Publisher:
Sage
Knowledge concerning professionals involved in dementia care throughout its trajectory is sparse; the focus has mainly been on nursing-home care and less on home care, diagnosis and treatment of the disease and its complications despite the fact that home care is the most prominent type of care. The aim of this study was to explore and describe professional care providers involved in dementia untrained staff were more common in some countries. Findings also show that many types of professionals are involved, who to turn to may not be clear, for instance in terms of medical specialities and it may be unclear who bears the ultimate responsibility. The professionals involved in diagnosis, treatment and care are educated to bachelor’s level or above whilst everyday care is provided by people
(Publisher abstract)
Knowledge concerning professionals involved in dementia care throughout its trajectory is sparse; the focus has mainly been on nursing-home care and less on home care, diagnosis and treatment of the disease and its complications despite the fact that home care is the most prominent type of care. The aim of this study was to explore and describe professional care providers involved in dementia care and their educational level applying the International Standard Classification of Education (ISCED) and further to investigate practice in the RightTimePlaceCare-countries with regard to screening, diagnostic procedures and treatment of dementia and home care. The findings demonstrate more similarities than differences in terms of type of professionals involved among the countries although untrained staff were more common in some countries. Findings also show that many types of professionals are involved, who to turn to may not be clear, for instance in terms of medical specialities and it may be unclear who bears the ultimate responsibility. The professionals involved in diagnosis, treatment and care are educated to bachelor’s level or above whilst everyday care is provided by people trained at a lower ISCED level or with no formal training. Registered nurses as well as occupational therapists have bachelor’s degrees in most countries, but not in Germany or Estonia. Professionals specifically trained in dementia care are not so common. Further research is needed to reveal not only who provides the diagnostics and treatment, but also how home care is organised and quality assured. Many different types of professionals serve as providers along the trajectory of the disease which may be difficult for the patient and the informal caregiver to cope with.
(Publisher abstract)
Subject terms:
dementia, training, participation, diagnosis, treatment, service provision, knowledge management, professionals, professional role, screening;
Content type:
research
Location(s):
United Kingdom, Finland, Netherlands, Spain, Germany, Sweden, Estonia
International Journal of Geriatric Psychiatry, 22(4), April 2007, pp.294-304.
Publisher:
Wiley
This Spanish study aimed to design and validate a new screening test for amnestic Mild Cognitive Impairment (A-MCI) and early stage Alzheimer's disease (AD). The authors develop a verbal episodic and semantic memory test: the Memory Alteration Test. Discriminative validity was assessed in a population sample of 400 aged individuals from primary care population centres in Barcelona, Spain, 50 patients with A-MCI according to Petersen et al. criteria, and 66 with early AD (Global Deterioration Scale - 4 stage) according to the NINCDS-ADRDA criteria. The Memory Alteration Test is a quick, 5-minute, and easy to administer and to score. The results found that the Memory Alteration Test provides efficient and valid screening for A-MCI and early stage AD, and discriminates between A-MCI and early AD patients.
This Spanish study aimed to design and validate a new screening test for amnestic Mild Cognitive Impairment (A-MCI) and early stage Alzheimer's disease (AD). The authors develop a verbal episodic and semantic memory test: the Memory Alteration Test. Discriminative validity was assessed in a population sample of 400 aged individuals from primary care population centres in Barcelona, Spain, 50 patients with A-MCI according to Petersen et al. criteria, and 66 with early AD (Global Deterioration Scale - 4 stage) according to the NINCDS-ADRDA criteria. The Memory Alteration Test is a quick, 5-minute, and easy to administer and to score. The results found that the Memory Alteration Test provides efficient and valid screening for A-MCI and early stage AD, and discriminates between A-MCI and early AD patients.
International Journal of Geriatric Psychiatry, 19(12), December 2004, pp.1173-1180.
Publisher:
Wiley
The aim was to determine whether selective memory impairment (SMI) on an adapted Mini-Mental State Examination (aMMSE) test increases risk of future dementia in a population-based survey of central Spain. SMI is a strong predictor of dementia in the elderly. However, most approaches have used extensive memory batteries, which are not always suitable for screening purposes. The basal cohort consisted of 2982 poorly educated individuals aged 65 or over. Dementia, stroke and parkinsonism cases were previously excluded. At entry, participants received a structured interview including an aMMSE. Two groups were created according to basal cognitive performance, namely: (1) aMMSE > 23 and no word remembered on the aMMSE delayed-recall task (SMI group); and (2) aMMSE > 23 and at least one word remembered on the delayed-recall task (control group). In a three-year follow-up wave, conversion rate to dementia was calculated and logistic regression was performed. Of a total of 2507 subjects who completed the two evaluations, 280 qualified for SMI at entry. In the SMI group, 25 subjects (8.9%) developed dementia vs 26 subjects (1.2%) in the control group. Taking the two groups together, and once demographic and medical variables had been controlled, a low delayed-recall score increased dementia conversion rate (OR 0.47, 95% CI 0.34-0.64). Alzheimer's disease was the main cause of dementia (79.8%). Memory impairment is a risk factor for future dementia in the neurologically-healthy elderly. This can be observed in a subgroup of subjects with SMI defined on the aMMSE delayed-recall subscore. Some other measurements should be added to the SMI construct to improve its predictive validity.
The aim was to determine whether selective memory impairment (SMI) on an adapted Mini-Mental State Examination (aMMSE) test increases risk of future dementia in a population-based survey of central Spain. SMI is a strong predictor of dementia in the elderly. However, most approaches have used extensive memory batteries, which are not always suitable for screening purposes. The basal cohort consisted of 2982 poorly educated individuals aged 65 or over. Dementia, stroke and parkinsonism cases were previously excluded. At entry, participants received a structured interview including an aMMSE. Two groups were created according to basal cognitive performance, namely: (1) aMMSE > 23 and no word remembered on the aMMSE delayed-recall task (SMI group); and (2) aMMSE > 23 and at least one word remembered on the delayed-recall task (control group). In a three-year follow-up wave, conversion rate to dementia was calculated and logistic regression was performed. Of a total of 2507 subjects who completed the two evaluations, 280 qualified for SMI at entry. In the SMI group, 25 subjects (8.9%) developed dementia vs 26 subjects (1.2%) in the control group. Taking the two groups together, and once demographic and medical variables had been controlled, a low delayed-recall score increased dementia conversion rate (OR 0.47, 95% CI 0.34-0.64). Alzheimer's disease was the main cause of dementia (79.8%). Memory impairment is a risk factor for future dementia in the neurologically-healthy elderly. This can be observed in a subgroup of subjects with SMI defined on the aMMSE delayed-recall subscore. Some other measurements should be added to the SMI construct to improve its predictive validity.
British Medical Journal, 5.11.94, 1994, pp.1218-1221.
Publisher:
British Medical Association
Despite legislation to harmonise mental health practice throughout Europe and convergence in systems of training there remains an extraordinary diversity of psychiatric practice in Europe. Approaches to tackling substance misuse vary among nations; statistics on psychiatric morbidity are affected by different approaches to diagnosis and treatment of psychiatric disorders; attitudes towards mental
Despite legislation to harmonise mental health practice throughout Europe and convergence in systems of training there remains an extraordinary diversity of psychiatric practice in Europe. Approaches to tackling substance misuse vary among nations; statistics on psychiatric morbidity are affected by different approaches to diagnosis and treatment of psychiatric disorders; attitudes towards mental illness show definite international differences. Everywhere, though, mental health care for patients with psychotic illness is a "cinderella service", and there is a general move towards care falling increasingly on the family and the community.
Subject terms:
law, mental health, mental health problems, mental health services, psychiatry, social care provision, treatment, therapy and treatment, training, attitudes, community care, diagnosis, families;